Suggestions for Hernia. Here are some tips that help in managing hernia symptoms: Maintain a healthy body weight by following a low-calorie, nutritious diet.
Hernia Surgery Explained in Detail. What is a Hernia? A hernia happens when there is a hole or a weakness in a muscle that allows organs or tissue to bulge through the defect. Hernias range in severity from barely noticeable to life- threatening, depending on the size of the defect and the organs involved. List of Hernia Symptoms. Commonly Known Hernia Types. Hernia is very painful and the movement of the part where it occurs is definitely.In some cases, hernia surgery is performed to remove the annoying or unsightly bulge; in other cases, severe organ damage can occur if surgery is not performed immediately to repair the problem. A hernia can happen in many different areas of the body. The most common, though, are in the abdomen and groin areas. Common Types of Hernias – From Hernia Diagnosis to Surgery and Recovery. Commonly Used Hernia Terms. There are many terms that are used when a hernia is diagnosed to describe the severity and the origin of a hernia. Some types of hernias change in size when abdominal pressure increases. Abdominal pressure is increased with activities, such as coughing or sneezing, crying (children) and bearing down to have a bowel movement. A hernia that bulges out with abdominal pressure but returns inside the body when the pressure is gone or with gentle pressure from the outside, is referred to as reducible. Hernias that remain in the “out” position are called “irreducible. This can become an emergency if it begins to “strangulate,” meaning that the bulging tissue loses blood flow. A strangulated hernia is an emergency. A hernia can be an acquired activity, meaning that it develops with age, or due to a surgery or procedure. A congenital hernia is present at birth, also known as a birth defect. When Is a Hernia an Emergency? A hernia becomes an emergency when there is severe pain at the site, which is often caused by a lack of blood flow to the tissue bulging through the muscle. A change in the color of the hernia may also indicate a serious problem. It may become dusky, meaning it is gray or ashen in color, or it can become dark red or purple. These types of color changes can indicate that the blood flow has been cut off and the hernia is strangulating. Recovering from Hernia Surgery. There is no standard recovery from hernia surgery as there are many types of hernias. Some hernia surgeries are large and extensive procedures, while others can be performed on an outpatient basis with the patient returning home the same day. Hernia Prevention After Surgery. Some types of hernias can be prevented. One of the easiest ways to prevent an incisional hernia is to protect a surgical incision while it heals. This means that if you are rising from a seated position, have to sneeze or cough or are bearing down from a bowel movement, you should gently hold pressure on the incision until the activity is over. Another important way to prevent an incisional hernia is to follow the surgeon’s instructions, regarding how long to wait before lifting anything, especially heavy objects. Hernia Prevention While Lifting Objects. Some types of hernias can be caused or made worse by lifting heavy objects with improper techniques. Using good techniques, such as using your leg muscles to lift instead of using your back or leg muscles, can help prevent some types of hernias. If you’ve ever lifted a heavy object and had someone say, “You’re going to give yourself a hernia,” you may need to evaluate the way you lift heavy objects. Additional Information: Answers to Common Questions After Surgery. Sources: Congenital Diaphragmatic Hernia. The University of Michigan Health System. The Lucile Packard Children’s Hospital at Stanford http: //www. Hernia Surgery. National Institutes of Health http: //www. Inguinal Hernia Surgery. National Institutes of Health http: //www. Hernia - Wikipedia. Hernia. Diagram of an indirect inguinal hernia (view from the side). Specialty. General surgery. Symptoms. Pain especially with coughing, bulging area. Most commonly they involve the abdomen, specifically the groin. This may include pain or discomfort especially with coughing, exercise, or going to the bathroom. Often it gets worse throughout the day and improves when lying down. A bulging area may occur that becomes larger when bearing down. Groin hernias occur more often on the right than left side. The main concern is strangulation, where the blood supply to part of the bowel is blocked. This usually produces severe pain and tenderness of the area. It is unclear if groin hernias are associated with heavy lifting. Hernias can often be diagnosed based on signs and symptoms. Occasionally medical imaging is used to confirm the diagnosis or rule out other possible causes. Repair, however, is generally recommended in women due to the higher rate of femoral hernias which have more complications. If strangulation occurs immediate surgery is required. Repair may be done by open surgery or by laparoscopic surgery. Open surgery has the benefit of possibly being done under local anesthesia rather than general anesthesia. Laparoscopic surgery generally has less pain following the procedure. The medications, H2 blockers or proton pump inhibitors may help. If the symptoms do not improve with medications the surgery known as laparoscopic fundoplication may be an option. Another common hernia involves the spinal discs and causes sciatica. A hiatus hernia occurs when the stomach protrudes into the mediastinum through the esophageal opening in the diaphragm. Hernias may or may not present with either pain at the site, a visible or palpable lump, or in some cases more vague symptoms resulting from pressure on an organ which has become . Fatty tissue usually enters a hernia first, but it may be followed or accompanied by an organ. Hernias are caused by a disruption or opening in the fascia, or fibrous tissue, which forms the abdominal wall. It is possible for the bulge associated with a hernia to come and go, but the defect in the tissue will persist. Symptoms and signs vary depending on the type of hernia. Symptoms may or may not be present in some inguinal hernias. In the case of reducible hernias, a bulge in the groin or in another abdominal area can often be seen and felt. When standing, such a bulge becomes more obvious. Besides the bulge, other symptoms include pain in the groin that may also include a heavy or dragging sensation, and in men, there is sometimes pain and swelling in the scrotum around the testicular area. They may be chronic, although painless, and can lead to strangulation (loss of blood supply) and/or obstruction (kinking of intestine). Strangulated hernias are always painful and pain is followed by tenderness. Nausea, vomiting, or fever may occur in these cases due to bowel obstruction. Also, the hernia bulge in this case may turn red, purple or dark and pink. In the diagnosis of abdominal hernias, imaging is the principal means of detecting internal diaphragmatic and other nonpalpable or unsuspected hernias. Multidetector CT (MDCT) can show with precision the anatomic site of the hernia sac, the contents of the sac, and any complications. MDCT also offers clear detail of the abdominal wall allowing wall hernias to be identified accurately. Among the multiple causes, however, are the mechanical causes which include: improper heavy weight lifting, hard coughing bouts, sharp blows to the abdomen, and incorrect posture. Some examples would be: obesity, straining during a bowel movement or urination (constipation, enlarged prostate), chronic lung disease, and also, fluid in the abdominal cavity (ascites). They contend that the risk of hernia is due to a physiological difference between patients who suffer hernia and those who do not, namely the presence of aponeurotic extensions from the transversus abdominis aponeurotic arch. If this type of hernia is due to blunt trauma it is an emergency condition and could be associated with various solid organs and hollow viscus injuries. Diagnosis. Inguinal hernias are further divided into the more common indirect inguinal hernia (2/3, depicted here), in which the inguinal canal is entered via a congenital weakness at its entrance (the internal inguinal ring), and the direct inguinal hernia type (1/3), where the hernia contents push through a weak spot in the back wall of the inguinal canal. Inguinal hernias are the most common type of hernia in both men and women. In some selected cases, they may require surgery. There are special cases in which the hernia may contain both direct and indirect hernia simultaneously pantaloon hernia, or, though very rare, may contain simultaneous indirect hernias. They can be hard to distinguish from the inguinal type (especially when ascending cephalad): however, they generally appear more rounded, and, in contrast to inguinal hernias, there is a strong female preponderance in femoral hernias. The incidence of strangulation in femoral hernias is high. Repair techniques are similar for femoral and inguinal hernia. A Cooper's hernia is a femoral hernia with two sacs, the first being in the femoral canal, and the second passing through a defect in the superficial fascia and appearing almost immediately beneath the skin. Umbilical. Umbilical hernias in adults are largely acquired, and are more frequent in obese or pregnant women. Abnormal decussation of fibers at the linea alba may contribute. Incisional. When these occur in median laparotomy incisions in the linea alba, they are termed ventral hernias. These can be the most frustrating and difficult to treat, as the repair utilizes already attenuated tissue. Diaphragmatic. Hiatus hernias may be either . Non- sliding or para- esophageal hernias can be dangerous as they may allow the stomach to rotate and obstruct. Repair is usually advised. A congenital diaphragmatic hernia is a distinct problem, occurring in up to 1 in 2. Intestinal organs may herniate through several parts of the diaphragm, posterolateral (in Bochdalek's triangle, resulting in Bochdalek's hernia), or anteromedial- retrosternal (in the cleft of Larrey/Morgagni's foramen, resulting in Morgagni- Larrey hernia, or Morgagni's hernia). The above article deals mostly with . Other hernia types and unusual types of visceral hernias are listed below, in alphabetical order. Patient with a colostomy complicated by a large parastomal hernia. Parastomal hernias, which is when tissue protrudes adjacent to a stoma tract. Paraumbilical hernia: a type of umbilical hernia occurring in adults. Perineal hernia: a perineal hernia protrudes through the muscles and fascia of the perineal floor. It may be primary but usually is acquired following perineal prostatectomy, abdominoperineal resection of the rectum, or pelvic exenteration. Properitoneal hernia: rare hernia located directly above the peritoneum, for example, when part of an inguinal hernia projects from the deep inguinal ring to the preperitoneal space. Richter's hernia: a hernia involving only one sidewall of the bowel, which can result in bowel strangulation leading to perforation through ischaemia without causing bowel obstruction or any of its warning signs. It is named after German surgeon August Gottlieb Richter (1. Sliding hernia: occurs when an organ drags along part of the peritoneum, or, in other words, the organ is part of the hernia sac. The colon and the urinary bladder are often involved. The term also frequently refers to sliding hernias of the stomach. Sciatic hernia: this hernia in the greater sciatic foramen most commonly presents as an uncomfortable mass in the gluteal area. Bowel obstruction may also occur. This type of hernia is only a rare cause of sciatic neuralgia. Sports hernia: a hernia characterized by chronic groin pain in athletes and a dilated superficial inguinal ring. Velpeau hernia: a hernia in the groin in front of the femoral blood vessels. Treatment. Time needed for recovery after treatment is reduced if hernias are operated on laparoscopically. However, open surgery can be done sometimes without general anesthesia. Uncomplicated hernias are principally repaired by pushing back, or . If complications have occurred, the surgeon will check the viability of the herniated organ and remove part of it if necessary. Muscle reinforcement techniques often involve synthetic materials (a mesh prosthesis). At times staples are used to keep the mesh in place. These mesh repair methods are often called . However, this widely used terminology is misleading, as there are many tension- free suture methods that do not use mesh (e. Desarda, Guarnieri, Lipton- Estrin, etc.). Evidence suggests that tension- free methods (with or without mesh) often have lower percentage of recurrences and the fastest recovery period compared to tension suture methods. However, among other possible complications, prosthetic mesh usage seems to have a higher incidence of chronic pain and, sometimes, infection. People who have their hernias repaired with mesh often recover in a number of days, though pain can last longer. Surgical complications include pain that lasts more than three months, surgical site infections, nerve and blood vessel injuries, injury to nearby organs, and hernia recurrence. Pain that lasts more than three months occurs in about 1. In the event of a mesh rejection, the mesh will very likely need to be removed. Mesh rejection can be detected by obvious, sometimes localised swelling and pain around the mesh area. Continuous discharge from the scar is likely for a while after the mesh has been removed. A surgically treated hernia can lead to complications, while an untreated hernia may be complicated by: Epidemiology. Groin hernias in adults. The New England Journal of Medicine. The 5- minute clinical consult 2. Philadelphia, Pa.: Wolters Kluwer Health/Lippincott Williams & Wilkins. BMJ (Clinical research ed.). Lancet (London, England).
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